The Fulkerson osteotomy is an operation to re-align the tibial tuberosity antero-medially to alter the direction of the forces going through the kneecap.

fulkerson osteotomy
The patellar tendon is both medialised (moved towards the inner aspect) and brought anteriorly (moved forwards).


What is distal realignment?

The Fulkerson osteotomy is one of a group of procedures to realign the patella (kneecap) distally (ie the lower end of the patella-tendon complex. Other distal realignment procedures include:

  • Maquet procedure
  • Elmslie-Trillat procedure
  • Hauser procedure
  • Roux-Goldthwait procedure
  • many variants and modifications
Fulkerson procedure
Anteromedialisation of the tibial tubercle

Distal realignment procedures

Realigning the kneecap by surgical procedures below the kneecap.

Surgical procedures to correct patellar alignment

Non-surgical treatment is generally the first choice of management, but surgery may be necessary.

Surgery for patellar malalignment

Part 8 of a course on Patellofemoral Pain by Dr Ronald Grelsamer of Mount Sinai Hospital in New York.



Osteotomy of the Tibial Tubercle for Anteromedialization. Ferrari MB, Sanchez G, Kennedy NI, Sanchez A, Schantz K and Provencher MT. Arthrosc Tech. 2017 Aug; 6(4): e1341–e1346.

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